Urealyticum Isolates Research Articles

Determination of In Vitro Antimicrobial Susceptibility for Lefamulin (Pleuromutilin) for Ureaplasma Spp. and Mycoplasma hominis.

Lefamulin is the first of the pleuromutilin class of antimicrobials to be available for therapeutic use in humans. Minimum inhibitory concentrations of lefamulin were determined by microbroth dilution for 90 characterised clinical isolates (25 Ureaplasma parvum, 25 Ureaplasma urealyticum, and 40 Mycoplasma hominis). All Mycoplasma hominis isolates possessed lefamulin MICs of ≤0.25 mg/L after 48 h (MIC50/90 of 0.06/0.12 mg/L), despite an inherent resistance to macrolides; while Ureaplasma isolates had MICs of ≤2 mg/L after 24 h (MIC50/90 of 0.25/1 mg/L), despite inherent resistance to clindamycin. Two U. urealyticum isolates with additional A2058G mutations of 23S rRNA, and one U. parvum isolate with a R66Q67 deletion (all of which had a combined resistance to macrolides and clindamycin) only showed a 2-fold increase in lefamulin MIC (1–2 mg/L) relative to macrolide-susceptible strains. Lefamulin could be an effective alternative antimicrobial for treating Ureaplasma spp. and Mycoplasma hominis infections irrespective of intrinsic or acquired resistance to macrolides, lincosamides, and ketolides. Based on this potent in vitro activity and the known good, rapid, and homogenous tissue penetration of female and male urogenital tissues and glands, further exploration of clinical efficacy of lefamulin for the treatment of Mycoplasma and Ureaplasma urogenital infections is warranted.

Epidemiological investigation and antimicrobial susceptibility analysis of Ureaplasma and Mycoplasma hominis in a teaching hospital in Shenyang, China

ObjectivesThe aim of this study was to estimate the prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in a comprehensive teaching hospital Shenyang, China over the past 4 years. MethodsA total of 1448 individuals with urogenital symptoms underwent mycoplasma testing between April 2016 and March 2020. Detection, identification and antimicrobial susceptibility testing were carried out using Mycoplasma ID/AST kits. ResultsThe total infection rate of genital mycoplasmas was 37.5% (543/1448 cases) with an observed increase over the past 4 years. The positive rates of all three detected infections, as well as overall infection rate, were significantly higher in females than in males (P < 0.05). A higher positive rate of infection was observed in females aged 25–29 (60.5%), and in the 15–19 years age group (57.7%). The changes observed among all age groups of females were statistically significantly different (P < 0.001). The positive rates of U. urealyticum and M. hominis co-infection among the four seasons during which the survey was carried out were also observed to be statistically different (P = 0.01). More than 70% of U. urealyticum isolates were found to be resistant to ciprofloxacin, and more than 80% of M. hominis isolates were resistant to erythromycin, roxithromycin, azithromycin and clarithromycin. Josamycin, doxycycline and minocycline were most effective against U. urealyticum and M. hominis. ConclusionsResults of this study found increasing rates of U. urealyticum and M. hominis infection over the past 4 years, particularly among younger age groups. U. urealyticum/Mycoplasma hominis screening among younger age cohorts are therefore strongly recommend to preventing the spread of pathogens. Monitoring antimicrobial resistance is important for preventing transmission of resistant strains of infection and for the management of antibiotics.

Whole-genome sequencing reveals misidentification of a multidrug-resistant urine clinical isolate as Corynebacterium urealyticum

ObjectivesCorynebacterium urealyticum is a non-diphtherial urease-producing clinically relevant corynebacterium associated with urinary tract infections. Most clinical C. urealyticum isolates are multidrug-resistant. Whole-genome sequencing (WGS) of C. urealyticum VH4248 isolated from a clinical urine sample at Hospital Universitario Marqués de Valdecilla, Santander, Spain, was performed to predict its antimicrobial resistance profile and to compare it with results of culture-based phenotypic antimicrobial susceptibility testing. MethodsClassical microbiological methods and VITEK® MS were used for isolation and initial identification of strain VH4248. Draft genome sequencing was performed on an Illumina HiSeq 2500 platform, followed by assembly and annotation using SPAdes and RAST. Resistance genes were identified through PATRIC, the Pathosystems Resource Integration Center. Average nucleotide identity (ANI) analysis was done using the EDGAR and OrthoANI databases. Antimicrobial susceptibility was determined by Etest. ResultsIsolate VH4248 was initially identified asC. urealyticum. Its genome size is 2 261 231 bp with 64.4% GC content. Genome-based identification tools showed an average 93.7% similarity between VH4248 and C. urealyticum genomes deposited in public databases. Therefore, this isolate must be classified as Corynebacterium sp. The blaA and ermX genes as well as a class 1 integron including the aadB and sul1 genes are present in the VH4248 genome. This isolate is highly resistant to ampicillin, erythromycin and trimethoprim/sulfamethoxazole, and moderately resistant to gentamicin and kanamycin. ConclusionsWGS is a powerful tool forCorynebacterium identification to species level and for detection of unusual resistance determinants, such as that encoded by the class 1 integron in isolate VH4248.

Turning the Tide against Antibiotic Resistance by Evaluating Novel, Halogenated Phenazine, Quinoline, and NH125 Compounds against Ureaplasma Species Clinical Isolates and Mycoplasma Type Strains.

Escalating levels of antibiotic resistance in mycoplasmas, particularly macrolide resistance in Mycoplasma pneumoniae and M. genitalium, have narrowed our antibiotic arsenal. Further, mycoplasmas lack a cell wall and do not synthesize folic acid, rendering common antibiotics, such as beta-lactams, vancomycin, sulfonamides, and trimethoprim, of no value. To address this shortage, we screened nitroxoline, triclosan, and a library of 20 novel, halogenated phenazine, quinoline, and NH125 analogues against Ureaplasma species and M. hominis clinical isolates from urine. We tested a subset of these compounds (n = 9) against four mycoplasma type strains (M. pneumoniae, M. genitalium, M. hominis, and Ureaplasma urealyticum) using a validated broth microdilution or agar dilution method. Among 72 Ureaplasma species clinical isolates, nitroxoline proved most effective (MIC90, 6.25 µM), followed by an N-arylated NH125 analogue (MIC90, 12.5 µM). NH125 and its analogue had significantly higher MICs against U. urealyticum isolates than against U. parvum isolates, whereas nitroxoline did not. Nitroxoline exhibited bactericidal activity against U. parvum isolates but bacteriostatic activity against the majority of U. urealyticum isolates. Among the type strains, the compounds had the greatest activity against M. pneumoniae and M. genitalium, with 8 (80%) and 5 (71.4%) isolates demonstrating MICs of ≤12.5 µM, respectively. Triclosan also exhibited lower MICs against M. pneumoniae and M. genitalium Overall, we identified a promising range of quinoline, halogenated phenazine, and NH125 compounds that showed effectiveness against M. pneumoniae and M. genitalium and found that nitroxoline, approved for use outside the United States for the treatment of urinary tract infections, and an N-arylated NH125 analogue demonstrated low MICs against Ureaplasma species isolates.

Occurrence of Ureaplasma urealyticumin in Women in the Northeast of Iran: Characterization of Resistance Trends

Objectives: The present study surveyed the prevalence of antibiotic resistance among Ureaplasma urealyticum in isolates from Gonabad (in the northeast of Iran) including susceptibility testing for U. urealyticum to different antibiotics. Materials and Methods: In this research, a total of 95 vaginal swab specimens were aseptically collected from women who were admitted to the Bohlool Teaching Hospital and Jahad Daneshgahi Center from April 2016 to April 2017. Culture and subsequently antibiotic susceptibility testing were performed according to the Mycoplasma IST 2 kit. Then the cupules were read and interpreted in 24 and 48 hours according to kit guidelines. Results: In the studied patients, 38 (40.4 %), 12 (12.8 %), and 11 (11.7%) cases were single positive for U. urealyticum, single positive for Mycoplasma hominis (M. hominis), and dually positive for U. urealyticum and M. hominis, respectively. The positive rates of genital U. urealyticum in the symptomatic and asymptomatic groups were 86.8% and 13.2%, respectively. The highest positive rate (42.1%) was found in the 26-30-year-old group. In addition, tetracycline (TET) and doxycycline (DOT) were the most effective antibiotics against isolates, and one strain was multi-drug resistant. The U. urealyticum resistance rates were more than 39% to erythromycin and pristinamycin, and more than 55% to ciprofloxacin. All U. urealyticum isolates with &lt;104 CFU/specimen were sensitive to all tested drugs. Conclusions: Although the emerging resistance to TETs among our isolates is alarming, these data show that the standard therapeutic regimen for urogenital infections caused by U. urealyticum is DOT, TET, and clarithromycin, leading to better outcomes in most respective patients.

Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in female outpatients, 2009-2013.

The aim of this study was to estimate the prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis among female outpatients treated for genital infection at a Chinese hospital from January 1, 2009 to December 31, 2013. Samples from 6051 female outpatients were analyzed using Mycoplasma Identification and Antimicrobial Susceptibility Testing (ID/AST). The overall prevalence of U. urealyticum was higher than the prevalence of single M. hominis infection (31.2% vs 0.7%) and coinfections (31.2% vs. 1.9%). The percentage of U. urealyticum and/or M. hominis detected in the 30-39 year age group was greater than in the other age groups. More than 94.6% of the U. urealyticum isolates, 100% of the M. hominis isolates, and 84.3% of the isolates from coinfections were susceptible to doxycycline, minocycline, and tetracycline. More than 69.2% of the U. urealyticum isolates were susceptible to azithromycin, erythromycin, clarithromycin, and roxithromycin, but > 95.6% of the M. hominis isolates and 89.6% of the isolates from coinfections were resistant to these antibiotics. Acetylspiramycin, sparfloxacin, levofloxacin, ciprofloxacin, and ofloxacin were inactive against more than one-half of the isolates. More than 75.6% of the M. hominis isolates were susceptible to spectinomycin, but >87.1% of the U. urealyticum and 93.3% of the coinfection isolates were resistant to this antibiotic. Isolates from three coinfections were completely resistant to the 14 antibiotics. The determination of antimicrobial susceptibility of these mycoplasma species is often crucial for optimal antimicrobial therapy of infected outpatients.

Serological investigation ofUreaplasma urealyticumin Korean preterm infants

PurposeUreaplasma colonization is related with perinatal complications in preterm infants. Little is known about the difference in virulence among various Ureaplasma urealyticum serovars. The aim of this study was to determine U. urealyticum serovars of preterm infants in order to assess whether any of the serovars were associated with bronchopulmonary dysplasia (BPD).MethodsThree hundred forty-four preterm infants with a gestational age less than 34 weeks admitted to Gangnam Severance Hospital neonatal intensive care unit from July 2011 to December 2012 were included in this study. Tracheal and gastric aspirations were conducted on infants to confirm Ureaplasma colonization. Ureaplasma colonization was confirmed in 9% of infants, of these, serovars were determined by real-time polymerase chain reaction.ResultsA total of 31 infants (gestational age, 29.3±3.1 weeks; birth weight, 1,170±790 g) were U. urealyticum positive. The Ureaplasma positive group treated for more days with oxygen and ventilation than the negative group (P<0.05). Histologic chorioamnionitis and moderate to severe BPD were more frequent in the Ureaplasma positive group than in the negative group (P<0.05). U. urealyticum isolates were either found to be a mixture of multiple serovars (32%), serovar 9 alone or combined with other serovars (39%), serovar 11 (26%), 2 (13%), 8 (10%), 10 (13%), and 13 (25%). No individual serovars were significantly associated with moderate to severe BPD and chorioamnionitis.ConclusionThis is the first study to describe the distribution of U. urealyticum serovars from Korean preterm infants. Ureaplasma-colonized infants showed higher incidence of BPD and chorioamnionitis.

Frequency of Ureaplasma Serovars in Respiratory Secretions of Preterm Infants at Risk for Bronchopulmonary Dysplasia

Ureaplasma respiratory tract colonization is associated with bronchopulmonary dysplasia (BPD) in preterm infants. Whether the 4 Ureaplasma parvum and 10 Ureaplasma urealyticum serovars differ in virulence is unknown. This study was conducted to determine the distribution of Ureaplasma serovars in respiratory secretions of a prospective cohort of preterm infants and to assess whether any of the serovars are associated with BPD. Serial endotracheal and/or nasopharyngeal aspirates were obtained for Ureaplasma culture and PCR from 136 infants of gestational age <33 weeks. All positive samples were speciated and serovars were determined by real-time PCR. A total of 51 (37.5%) infants were Ureaplasma-positive one or more times during the first month of life. Respiratory colonization was inversely related to gestational age. Sixty-five percent of infants <26 weeks compared with 31% infants ≥ 26 weeks were culture or PCR positive. U. parvum was more common (N = 32, 63%) than U. urealyticum (N = 17, 33%); both species were present in 2 samples. Serovars 3 and 6 alone and in combination accounted for 96% U. parvum isolates. U. urealyticum isolates were commonly a mixture of multiple serovars, with serovar 11 alone or combined with other serovars (10/17, 59%) being the most common serovar. No individual species or serovars or serovar mixtures were associated with moderate-to-severe BPD. U. parvum serovars 3 and 6 and U. urealyticum serovar 11 were the most common serovars detected in respiratory samples from a prospective cohort of preterm infants.

Simultaneous and rapid differential diagnosis of Mycoplasma genitalium and Ureaplasma urealyticum based on a polymerase chain reaction-restriction fragment length polymorphism

Objectives: The aim of this investigation was to simultaneously detect and differentiate Mycoplasma genitalium and Ureaplasma urealyticum in female patients suffering from genital complications by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). Materials and Methods: Genital swabs were taken from 210 patients. They were transported to the laboratory in phosphate-buffered saline. For PCR, samples were analysed with genus-specific MyUu-R and MyUu-F primers. This primer set, which was originally designed in our laboratory, amplified a 465 bp fragment (M. genitalium) and a 559 bp fragment (U. urealyticum). Samples containing a band of the expected sizes for the Mycoplasma strains were subjected to digestion with a restriction endonuclease enzyme of TaqI and Cac8I. Results: Of the 210 samples, a total of 100 (47.6%) samples were found to be positive for Mycoplasmas (seven M. genitalium isolates, 3.3%; and 89 U. urealyticum isolates, 42.4%), and coinfections with both species were detected in four samples (1.9%). The PCR-RFLP results showed that M. genitalium and U. urealyticum are different by enzyme patterns. Conclusion: PCR-RFLP offers a rapid and easily applicable protocol to simultaneous detection and differentiation of M. genitalium and U. urealyticum from clinical samples when specific primers and restriction enzymes are used.

In vitro activity of linezolid and 12 other antimicrobials against coryneform bacteria

Objectives To compare the in vitro activity of linezolid with 12 other antimicrobials against 190 strains of the coryneform bacteria, including 60 strains of C. amycolatum, 30 of C. striatum, 30 of C. jeikeium, 10 of C. urealyticum, 20 of B. casei, 20 of D. hominis and 20 of T. otitidis. Methods Minimum inhibitory concentrations (MICs) and time–death curves were carried out according to the recommendations of the Clinical and Laboratory Standards Institute (CLSI). Results Linezolid was very active against the 130 strains of the Corynebacterium species studied. Only the glycopeptides showed similar efficacy. In contrast, penicillin G, ampicillin, macrolides, lincosamides, fluoroquinolones and aminoglycosides showed generally high MICs. Among the β-lactams, only imipenem was active against the majority of strains of C. striatum and C. amycolatum, and, approximately half of the C. jeikeium and C. urealyticum isolates. Both Dermabacter hominis and Brevibacterium casei showed marked resistance against most of the antimicrobials tested, while Turicella otitidis only showed high MICs against macrolides and clindamycin. For all of them, linezolid, vancomycin and teicoplanin proved effective. The time–death curves showed linezolid to behave as a bacteriostatic agent (approximately 90% death rate). Such activity was more accentuated for C. amycolatum and C. striatum (reduction of 1.3 and 1.7 log 10 CFU/mL, respectively) than for C. jeikeium and C. urealyticum (reduction of 1.0 and 0.8 log 10, respectively). Conclusions Our results indicate that linezolid is active against coryneform bacteria. The efficacy of linezolid is equal to or even superior to that of the glycopeptides.

Corynebacterium urealyticum urinary tract infection in dogs and cats: 7 cases (1996–2003)

To identify clinical features of Corynebacterium urealyticum urinary tract infection in dogs and cats and antimicrobial susceptibility patterns of C urealyticum isolates. Retrospective study. 5 dogs and 2 cats. Medical records of dogs and cats for which C urealyticum was isolated from urine samples were reviewed. Isolates from clinical cases, along with previously lyophilized unsubtyped isolates of Corynebacterium spp collected between 1977 and 1995, were examined and, if subtyped as C urealyticum, tested for antimicrobial susceptibility. Signalment of infected animals was variable. Prior micturition disorders were common, and all animals had signs of lower urinary tract disease at the time C urealyticum infection was diagnosed. Median urine pH was 8.0; WBCs and bacteria were variably seen in urine sediment. In vitro antimicrobial susceptibility testing of 14 C urealyticum isolates revealed that all were susceptible or had intermediate susceptibility to chloramphenicol, tetracycline, and vancomycin and most were susceptible to enrofloxacin. Thickening of the bladder wall and accumulation of sediment were common ultrasonographic findings. Contrast radiography or cystoscopy revealed findings consistent with encrusting cystitis in 3 dogs. Infection resolved in 2 dogs following surgical debridement of bladder plaques and antimicrobial administration. In 2 other dogs and 1 cat treated with antimicrobials, infection with C urealyticum resolved, but urinary tract infection with a different bacterial species developed. Results suggest that preexisting urinary tract disorders are common in dogs and cats with C urealyticum infection. Treatment with appropriate antimicrobials in combination with surgical debridement might eliminate C urealyticum infection.

Species identification, slime production and oxacillin susceptibility in coagulase-negative staphylococci isolated from nosocomial specimens

Ninety-two coagulase negative staphylococci (CNS) (forty-five of clinical origin and forty-seven of environmental origin), collected in a hospital in San Luis, Argentina, from March to June, 1999, were identified to species level by the ID 32 Staph and API Staph System (bioMérieux). Slime production was investigated by the quantitative and qualitative methods. Oxacillin susceptibility was determined by the disk diffusion test (1 µg), the agar dilution method (0.125 to 4 mg/ml) and agar screen (6 µg/ml). The presence of mecA gene was investigated by PCR. The clinical CNS species most commonly isolated were S. epidermidis, S. haemolyticus, S. hominis and S. saprophyticus. The frequency of slime production by clinical and environmental isolates was similar (25/45 and 27/47, respectively) and the results obtained by the quantitative and the qualitative methods correlated well. The mecA gene was detected in all S. epidermidis, S. haemolyticus and S. hominis isolates, which were resistant to oxacillin by the phenotypic methods. However, this gene was not present in S. klossii, S. equorum, S. xylosus and S. capitis strains. The gene was neither found in two out of the six S. saprophyticus isolates, in two out of three S. cohnii subsp. urealyticum isolates and in two out of five S. cohnii subsp. cohnii isolates, all of which resulted oxacillin resistant according to MIC. The gene was not found in oxacillin-susceptible strains either. Most of the CNS isolates (enviromental and clinical) that were slime producers were found to be oxacillin resistant, which makes the early detection of these microorganisms necessary to prevent their dissemination in hospitals, particularly among immunocompromised patients.

Development of an enzyme-linked immunosorbent assay for serotyping ureaplasma urealyticum strains using monoclonal antibodies.

Ureaplasma urealyticum comprises 14 serotypes. The existing serotyping methods all use polyclonal antibodies. These methods are time-consuming and labor-intensive, and they cannot always be performed on primary isolates; in addition, the results are difficult to interpret. We developed a new enzyme-linked immunosorbent assay (ELISA) method using serotype-specific monoclonal antibodies (MAbs) to enable the serotyping of U. urealyticum isolates from primary broth cultures. Each of the 14 serotype reference strains was tested against 14 selected MAbs. Homologous reactions were very strong, while heterologous reactions were negligible. Three cross-reactions were observed: MAb 5 cross-reacted with serotype 2, MAb 14 cross-reacted with serotype 3, and MAb 8 cross-reacted with serotype 13. Despite the cross-reactions observed, all the serotype reference strains of U. urealyticum could be identified and differentiated using a combination of MAbs. Reproducibility was analyzed with a fractionated antigenic preparation and with several freshly prepared antigens of the same strain. No significant interrun variation was found with the fractionated antigen, but significant variations in optical density (OD) values were found when freshly prepared antigens were tested. However, the variation in OD values did not influence the overall interpretation of the ELISA: reactions with homologous MAbs were always prominent compared to those of the negative controls. This newly developed ELISA using MAbs seems promising for serotyping of U. urealyticum clinical isolates.

Biochemical, antimicrobial susceptibility and genotyping studies on Corynebacterium urealyticum isolates from diverse sources

Thirty-two isolates of Corynebacterium urealyticum, isolated between 1991 and 1995, were studied by biochemical tests, phospholipid content, analysis of fatty and mycolic acids, ribotyping, whole-cell protein patterns and antimicrobial susceptibility to six antibiotics. Nineteen isolates were from human and human-related sources (HHRS); the remainder were from animal and animal-related sources (AARS). Most C. urealyticum isolates were similar in their biochemical and whole-cell protein profiles, although most HHRS isolates were alkaline phosphatase-positive (84%) and produced almost identical protein patterns, whereas AARS isolates were quite diverse. The qualitative composition of cellular fatty acids was identical for all isolates examined. Twelve different ribotypes were obtained with HindIII producing four-to-seven bands. Ribotypes 8, 9 and 10 were predominant in isolates from HHRS, whereas in isolates from AARS, ribotypes 5 and 6 predominated. AARS isolates were significantly less antibiotic-resistant, in comparison with HHRS isolates. Ribotyping appeared to be the most useful tool for strain characterisation.

Species identification and subtyping of Ureaplasma parvum and Ureaplasma urealyticum using PCR-based assays.

There is good evidence that the organism currently known as Ureaplasma urealyticum should be divided into two species-U. parvum (previously U. urealyticum biovar 1) and U. urealyticum (previously U. urealyticum biovar 2). In this study, we designed a series of primers, targeting the 16S rRNA gene and 16S rRNA-23S rRNA intergenic spacer regions, the urease gene subunits, and the 5' ends of the multiple-banded antigen (MBA) genes, to identify and subtype these Ureaplasma species. All of the species-specific primer pairs could distinguish the two species, but only subtype-specific primer pairs targeting the MBA genes could distinguish subtypes within each species. U. parvum was separated into three subtypes, represented by serovars 1, 3/14, and 6. U. urealyticum was also separated into three subtypes by PCR and/or direct sequencing. Subtype 1 consisted of serovars 2, 5, 8, and 9; subtype 2 contained serovars 4, 10, 12, and 13; and subtype 3 contained serovars 7 and 11. A selection of primer pairs was used to identify and subtype 78 clinical ureaplasma isolates from vaginal swabs of pregnant women and to identify and subtype ureaplasmas directly in 185 vaginal swabs in which they had been previously detected. U. parvum was identified in 228 (87%) of 263 isolates or specimens, and U. urealyticum was identified in 50 (19%) (both were present in 6%). Serovars 3/14 (48%) and 1 (43%) were most common among U. parvum isolates, and subtypes 2 (62%) and 1 (34%) were most common among U. urealyticum isolates. This new PCR-based typing system will facilitate future studies of the relationship between individual Ureaplasma species or subtypes and human disease.

The phylogeny of Ureaplasma urealyticum based on the mba gene fragment.

Sequencing of mba gene fragments of reference strains of Ureaplasma urealyticum serovars 1, 3, 6, 14 and 8, in addition to 33 clinical U. urealyticum isolates is reported. A phylogenetic tree deduced from alignment of these sequences clearly demonstrates two major clusters (confidence limit 100%), which equate to the parvo and T960 biovars, and five types, which have been designated mba 1, 3, 6, 8 and X. These relationships are supported by bootstrap analysis. Polymorphisms within the mba fragment of types mba 1, 3 and 6 were used to define nine subtypes (mba 1a, 1b, 3a, 3b, 3c, 3d, 3e, 6a and 6b), thus facilitating high resolution typing of U. urealyticum. Inclusion of reference strains for serovars 1, 3, 6 and 8 in the mba typing scheme showed that the results of this analysis are broadly consistent with currently accepted serotyping. In addition, a ure gene fragment from nine of the clinical isolates was amplified and sequenced. Comparisons of the sequences clearly distinguished the two biovars of U. urealyticum; however, this fragment was invariant within the parvo biovar. This study has shown that the mba sequence can reveal the fine details of the relationships between U. urealyticum isolates and also supports the significant evolutionary gap between the two biovars.

Bacterial Pathogens in Male Patients With Urethritis in Īstanbul

A study conducted at the Medical Facility of Istanbul (Turkey) investigated the presence of bacterial pathogens in 486 male patients with urethritis. Patients had one or more complaints of urethral discharge dysuria or urethral pruritus and more than four polymorphonuclear leukocytes per oil-immersion field of Grams stain of urethral swabs. The explored bacteria were detected and confirmed by a second test in 316 of these patients. The bacteria isolated were Neisseria gonorrhoeae (n = 41 8.4%) Chlamydia trachomatis (n = 112 23%) Ureaplasma urealyticum (n = 175 36%) Haemophilus influenzae (n = 8 1.8%) Haemophilus parainfluenzae (n = 11 2.2%) and Gardnerella vaginalis (n = 2 0.4%). Of 42 N. gonorrhoeae strains 8 (19%) were resistant to penicillin G and 7 of these strains were penicillinase-producing N. gonorrhoeae; 1 isolate was resistant to tetracycline. The resistance rates of the 67 U. urealyticum isolates were 23.8% for ciprofloxacin 5.9% for tetracycline and 2.9% for minocycline. The high rate of penicillin G resistance in N. gonorrhoea and ciprofloxacin resistance to U. urealyticum underscores the need for conventional therapies to be reviewed and new schemes developed through systematic multicenter studies in communities where empiric therapy for sexually transmitted diseases is widely used.

Serum concentrations of erythromycin after intravenous infusion in preterm neonates treated for Ureaplasma urealyticum infection

Erythromycin is receiving renewed attention as an alternative for treatment of neonatal infections caused by Ureaplasma urealyticum because of recently proved abilities of this organism to produce systemic disease in this population. Although erythromycin has been used clinically for almost 40 years, very little is known about its activity in the preterm neonate. Fourteen neonates, birth weights < or = 1500 g and < or = 15 days of age, from whom U. urealyticum was isolated from the lower respiratory tract were randomized to receive erythromycin lactobionate either 25 or 40 mg/kg/day in four divided doses at 6-hour intervals scheduled for a total of 10 days. Blood samples collected at multiple time points after initial and steady state doses were assayed for erythromycin by liquid chromatography. Minimal inhibitory concentrations (MICs) of erythromycin for the U. urealyticum isolates were determined. MICs ranged from 0.031 to 2 micrograms/ml; MIC90 = 2 micrograms/ml. Serum erythromycin concentrations met or exceeded most MICs, with peak values of 3.05 to 3.69 and 1.92 to 2.9 micrograms/ml for the 40- and 25-mg/kg/day dosage groups, respectively. Pharmacokinetic parameters were calculated after the initial dose and at steady state for both dosage groups and compared. No adverse effects thought to be related to administration of erythromycin were observed. These preliminary findings showed that erythromycin is well-tolerated, has favorable pharmacokinetic activity in the preterm neonate and should be further investigated for treatment of ureaplasmal infections.

Identification and characterization of serotype 4-specific antigens of Ureaplasma urealyticum by use of monoclonal antibodies.

Monoclonal antibodies against Ureaplasma urealyticum serotype 4 were produced by immunizing BALB/c mice with whole-cell antigens of the U. urealyticum serotype 4 reference strain. Ten monoclonal antibodies differentiated into two groups were found: one group included five monoclonal antibodies recognizing a band in immunoblotting that had a molecular mass of 81 kDa, and a second group included another five monoclonal antibodies recognizing three bands in immunoblotting that had molecular masses of 81, 75, and 71 kDa. Fifteen clinical U. urealyticum isolates were selected for serotyping with serotype 4-specific monoclonal antibodies and polyclonal antisera 1 to 14. The results obtained with polyclonal and monoclonal antibodies suggest the existence of heterogeneity of the serotype antigens among clinical isolates of U. urealyticum serotype 4.

In Vitro Influence of Mycoplasma Species on the Stimulation of Human Polymorphonuclear Granulocytes

The influence of Mycoplasma species ( sp.) on the stimulation of human polymorphonuclear neutrophil granulocytes (PMNG) was determined by means of the luminol-dependent chemiluminescence (CL) method. When opsonized Mycoplasma sp. were used the CL response of PMNG was greater than in the presence of nonopsonized strains. Nonopsonized and nonspecifically opsonized Mycoplasma sp. showed a different CL response pattern. The stimulation of PMNG was with M. pneumoniae significantly weaker than with the other Mycoplasma sp. Using isolated M. hominis strains always the same CL-reaction of PMNG was observed. On the other hand, with 12 isolated U. urealyticum strains different results were obtained; 9 strains isolated from the upper urogenital tract lead to a slight PMNG stimulation comparable to that of M. pneumoniae. No correlation was found between CL response and bacterial killing. The weak stimulation of PMNG by M. pneumoniae and most of the U. urealyticum isolates suggest that this behaviour could be a factor of pathogenicity.